title: Successes of a national study of the Chronic Disease Self-Management Program: meeting the triple aim of health care reform.
abstract: BACKGROUND
  Emerging health care reform initiatives are of growing importance amidst concerns about providing care to increasing numbers of adults with multiple chronic conditions. Evidence-based self-management strategies are recognized as central to managing a variety of chronic diseases by improving the medical, emotional, and social role management demands of chronic conditions.
  
  
  OBJECTIVE
  To examine the effectiveness of the Chronic Disease Self-Management Program (CDSMP) among a national sample of participants organized around the Triple Aim goals of better health, better health care, and better value in terms of reduced health care utilization.
  
  
  METHODS
  Utilizing data collected from small-group CDSMP workshops, baseline, 6-month, and 12-month assessments were examined using 3 types of mixed-effects models to provide unbiased estimates of intervention effects.
  
  
  METHODS
  Data were analyzed from 1170 community-dwelling CDSMP participants.
  
  
  METHODS
  Triple Aim-related outcome measures: better health (eg, self-reported health, pain, fatigue, depression), better health care (eg, patient-physician communication, medication compliance, confidence completing medical forms), and better value [eg, reductions in emergency room (ER) visits and hospitalizations in the past 6 mo].
  
  
  RESULTS
  Significant improvements for all better health and better health care outcome measures were observed from baseline to 12-month follow-up. The odds of ER visits significantly reduced from baseline to 12-month follow-up, whereas significant reductions in hospitalization were only observed from baseline to 6-month follow-up.
  
  
  CONCLUSIONS
  This National Study of CDSMP (National Study) demonstrates the successful translation of CDSMP into widespread practice and its potential for helping the nation achieve the triple aims of health care reform.
authors.affiliation: *Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, School of Rural Public Health, College Station, TX †Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, Memphis, TN ‡Department of Epidemiology and Biostatistics, Texas A&M Health Science Center, School of Rural Public Health, College Station, TX §Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA ∥Department of Medicine, Stanford University, Stanford, CA ¶National Council on Aging, Washington, DC.
authors.forename: Marcia G
authors.initials: MG
authors.lastname: Ory
authors.forename: SangNam
authors.initials: S
authors.lastname: Ahn
authors.forename: Luohua
authors.initials: L
authors.lastname: Jiang
authors.forename: Matthew Lee
authors.initials: ML
authors.lastname: Smith
authors.forename: Philip L
authors.initials: PL
authors.lastname: Ritter
authors.forename: Nancy
authors.initials: N
authors.lastname: Whitelaw
authors.forename: Kate
authors.initials: K
authors.lastname: Lorig
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy*; D003142:Communication; D003863:Depression / Q000453:epidemiology; D015444:Exercise; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D018166:Health Care Reform; D006296:Health Services / Q000592:standards / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology; D019555:Physician-Nurse Relations; D011594:Psychometrics; D011787:Quality of Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D012648:Self Care / Q000379:methods / Q000706:statistics & numerical data*; D057566:Self Report